In a groundbreaking development, young children battling drug-resistant tuberculosis (TB) in India can now breathe a sigh of relief as the approval for an oral drug offers a beacon of hope. The Central TB Division’s recent update to treatment guidelines, endorsing the use of Delamanid for children under 5, marks a significant stride in paediatric TB care.

Previously restricted to children aged 6 and above, Delamanid’s approval for younger patients brings an end to the era of painful injectables, replacing them with an all-oral regimen. This approval, granted in March, paves the way for a less distressing treatment journey for infants and children suffering from multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB).

Dr. Sushant Mane, a national expert in the National TB Elimination Programme (NTEP), lauded this decision as transformational, offering relief not only to children but also to their families. The arduous 18-month treatment regimen, involving daily injections for six months, often inflicted not just physical pain but also psychological distress on young patients.

This milestone holds special significance for Mumbai, where a significant portion of TB cases are pre-XDR and XDR. Dr. Vikas Oswal, a chest physician and TB specialist, emphasised the relief this approval brings, especially considering the common occurrence of hearing difficulties associated with injectables.

While Delamanid marks a significant breakthrough, the wait continues for approval of Bedaquiline for younger children, a crucial component of the all-oral regimen. Nevertheless, this approval opens new avenues for paediatric TB treatment, offering hope to the 1.35 lakh children affected by TB in India in 2022, as per the latest India TB report.

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